NOV 12, 2015 01:30 PM PST

Opportunities to simplify clinical lipid assessment

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  • Professor of Endocrine Bone Research Laboratory, Univ of South Australia
      Professor Howard Morris is Professor of Medical Sciences at the University of South Australia and a Chief Medical Scientist in Chemical Pathology at SA Pathology, Adelaide, South Australia. He is currently Vice-President of the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) and Chair of the IFCC-International Osteoporosis Foundation Working Group on Standardization of Bone Marker Assays. He has over 30 years experience in Clinical Biochemistry largely managing the Endocrinology laboratory of a large public pathology service. Between 2003 and 2009 he was the Director of the Hanson Institute in Adelaide, the major medical research institute in South Australia. His research investigates the pathophysiology of osteoporosis and the effects of hormones including vitamin D and dietary calcium. He was the Louis Avioli Memorial Lecturer at the 2009 Annual Scientific Meeting of the American Society for Bone and Mineral Research. He is also Chair of the South Australian Department of Health Working Party on Osteoporosis and Fracture Prevention.
    • Clinical Associate Professor, Dept of Biochemistry, Royal Prince Alfred Hospital
        David Sullivan is a physician and chemical pathologist in the Department of Clinical Biochemistry at Royal Prince Alfred Hospital.  This includes conjoint appointment as Clinical Associate Professor, Central Clinical School, Faculty of Medicine and Charles Perkins Centre, University of Sydney. David has a long-term interest in lipid metabolism with particular emphasis on the gene environment interactions contributing to cardiovascular disease. He has been involved in the early use of many forms of lipid-lowering intervention. He remains a national leader of efforts to improve the detection and management of severe inherited dyslipidaemia, such as that seen in Familial Hypercholesterolaemia. David has experience in several international clinical posts, including World Health Organization (WHO) Fellowship at the MRC Lipoprotein Unit, Royal Postgraduate School of Medicine, Hammersmith Hospital, London and co-ordination of international clinical studies from the WHO reference lipid laboratory in Wageningen, Netherlands. In addition to his clinical activities in Australia, he has served on numerous clinical committees including the management committees of the LIPID and FIELD trials. Current research interests are focussed on biomarkers, post-prandial metabolism and novel therapies.


      The assessment of serum lipid and lipoprotein levels is a common procedure which affects the management of the risk of atherothrombotic cardiovascular disease (CVD) in large numbers of patients. Traditionally, this led to interpretive comments based on fasting levels of total and HDL cholesterol and calculated or direct measurement of LDL cholesterol (LDL-C). Recent developments have encouraged a broader perspective in which lipid results are considered in the context of other clinical factors. A patient-centred approach favours the consideration of a range of clinical factors, few of which are provided on test request forms. It is increasingly appropriate for lipid results to be discussed in a consultative fashion so that these additional clinical details can be included. Nevertheless, basic lipid results often serve to frame the relevant question and encourage an iterative exchange which might lead to more detailed investigation. Furthermore, new perspectives are emerging concerning the roles of LDL-C, triglyceride, HDL cholesterol and genetic influences. This presentation will consider common scenarios such as predominant hypercholesterolaemia, mixed hyperlipidaemia, massive hypertriglyceridaemia, primary genetic dyslipidaemia and secondary dyslipidaemia. Clinical and therapeutic contexts such as secondary prevention and statin intolerance will also be discussed.

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